Doctors testing acupuncture as pain treatment on medical flights

An article and caption on Jan. 19 about acupuncture being tested on air evacuation flights misidentified the head of nursing research for Europe Regional Medical Command. She is Army Lt. Col. Nancy Steele, not Lt. Col. Betty Garner.

RAMSTEIN AIR BASE, Germany — For the first time, doctors are testing acupuncture to treat injured troops in transit from Ramstein to the States.

The servicemembers are part of a study, looking at whether battlefield acupuncture — a procedure that involves placing tiny needles into troops’ ears — can be effectively used to control pain during an air evacuation.

Air Force Dr. (Col.) Richard Niemtzow, who developed the technique in 2001, said the needles would not replace painkillers during the flight, which lasts about seven hours. But he hopes the study will show that the acupuncture allows injured troops to take reduced doses of narcotics during the long flight to Joint Base Andrews in Maryland.

“We are approaching this in a safe and scientific manner. These people are not being taken advantage of because they are hurting,” he said. “We’re hoping that there is a benefit, but it may show that it is not useful.”

On a combat evacuation, where even the rattle of a flight can make broken bones much more painful, morphine and other opiate painkillers are typically given to injured troops. And as more troops return from the battlefield with pain, the military has seen a spike in the number of prescriptions for opiate painkillers. More troubling, abuse of painkillers is on the rise: About 22 percent of soldiers admitted misusing prescribed drugs, mostly painkillers, in a 12-month period, according to the results of a Pentagon survey released last year.

As a way to reduce the number of painkillers given to servicemembers, the military has turned to acupuncture as a potential alternative, using it to reduce long-term pain in veterans, as well as using Niemtzow’s technique to ease troops’ aches and strains downrange since 2009.

For this study, volunteers will be solicited prior to the evacuation. They will then be asked to fill out surveys about their pain symptoms before and during the flight.

Joan Walter, vice president of military medical research for the Samueli Institute in Alexandria, Va., said she expects to have about 60 to 70 participants during the 90-day study, which is being funded by the Air Force. Injuries to the servicemembers will likely include headaches, chronic muscular and skeletal pain, and broken limbs from roadside bomb attacks or motor vehicle accidents.

Niemtzow and his colleagues stressed that this study is not meant to prove acupuncture’s efficacy, something that is still debated among researchers and doctors, despite its 5,000-year history. The study is simply trying to determine whether troops feel that acupuncture is a benefit to them on the flight, as well as whether medical personnel can perform the procedure easily during an evacuation.

“We are asking in the environment of an aeromedical evacuation: Does this show promise?” he said. “Can this can be substituted in place of habit-forming medication or other medications with side effects? It’s a feasibility study.”

Small enough that they can be worn beneath headphones or a helmet, the needles are inserted into any of five points in the ear. Niemtzow hypothesizes that the ear acts as an intermediary when pain signals pass from the central nervous system to the brain, and those signals can be intercepted and manipulated by the needles to stop or lessen pain.

“We think that the insertion of the needles into the ear turns off the pain signal,” he said. “They still have the pathological condition, but there is a reduction in the perception of pain.”

At Ramstein’s Contingency Aeromedical Staging Facility, Sgt. 1st Class Joshua Friedbauer signed up to be one of the first servicemembers in the study. Army Lt. Col. Nancy Steele, head of nursing research for European Regional Medical Command, pricked his ears with several needles: some gold, others silver and platinum.

“I never thought I would go for earrings,” he said.

Friedbauer, of the Army National Guard’s 20th Special Forces Group, had been directing traffic at Bagram Air Base in Afghanistan when a forklift, carrying 2,200 gallons of diesel fuel, slammed into his back — tearing his shoulder. Doctors said he would need to have rotator cuff surgery immediately, and he was now awaiting a flight home.

Minutes after being stuck with needles, Friedbauer raised his right arm.

“I was very skeptical,” he said. “But I can’t believe the difference. My shoulder and back feel better, and I have more movement in my arm.”

Another patient, Army Sgt. 1st Class Joseph Smith, of the 47th Ordnance Company, said his back pain, which made him wince every time he bent over, had greatly diminished after the acupuncture.

“This may,” he said, “be an enjoyable flight after all.”

robbinss@estripes.osd.mil

Sgt. 1st Class Joshua Friedbauer receives acupuncture just prior to his flight to the States. Friedbauer, of the Army National Guard's 20th Special Forces Group, is one of the first participants in a study examining whether acupuncture can effectively be used in air evacuation flights.
Seth Robbins/Stars and StripesSeth Robbins/Stars and Stripes